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. 2016 Apr;6(2):138-43.
doi: 10.21037/cdt.2016.02.03.

Assessment of the effect of off-pump coronary artery bypass (OPCAB) surgery on right ventricle function using strain and strain rate imaging

Mohammad Khani  1 , Mahsa Hosseintash  1 , Mahnoosh Foroughi  1 , Mohammadreza Naderian  1 , Isa Khaheshi  1
Affiliations

Assessment of the effect of off-pump coronary artery bypass (OPCAB) surgery on right ventricle function using strain and strain rate imaging

Mohammad Khani et al. Cardiovasc Diagn Ther. 2016 Apr.

Abstract

Background: Right ventricle function significantly decreases after coronary artery bypass surgery; as one of the likely causes, such a condition is attributed to the use of cardiopulmonary pump (CPB). Because nowadays there is a tendency toward increasing use of off-pump coronary artery bypass (OPCAB) surgery, this study was conducted to evaluate the right ventricle function after this type of surgery using strain and strain rate imaging (SRI) echocardiography.

Methods: This study was conducted on 30 patients, candidate for elective OPCAB surgery, between 2011 and 2012. Standard echocardiography was performed before the surgery and the right ventricle function was examined using strain and SRI echocardiography. Then patient underwent surgery, 6 days and 3 months after surgery they underwent echocardiography again and the results obtained from the three stages were compared with each other.

Results: Participants included 30 patients (23 males and 7 females) with a mean age of 66±11 years. Compared to the prior of the surgery, 6 days and 3 months after the surgery there was a significant decrease in tricuspid annular plane systolic excursion (TAPSE), tissue Doppler imaging (TDI) at the lateral annulus of tricuspid valve, and strain and SRI of right ventricle. However, the values obtained 3 months after surgery were significantly higher than those obtained after 6 days. In other words, the right ventricle function 6 days after the surgery had dropped, however some of the values recovered 3 months after the surgery.

Conclusions: The findings of this study are consistent with other studies in this field and showed that after coronary artery surgery a decline occurs in right ventricular function. However, more detailed quantitative strain and SRI parameters which were measured in our study showed that at the early days after the OPCAB surgery there is a decline in the right ventricle function which is relatively reversible at longer intervals (3 months after surgery).

Keywords: Right ventricle function; off-pump coronary artery bypass surgery (OPCAB surgery); off-pump coronary artery bypass surgery (OPCAB); strain and strain rate imaging echocardiography (strain and SRI echocardiography).

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Comparison of tricuspid annular plane systolic excursion (TAPSE) prior to, 6 days, and 3 months after OPCAB.
Figure 2
Figure 2
Comparison of tissue Doppler index (TDI) prior to, 6 days, and 3 months after OPCAB.
Figure 3
Figure 3
Comparison of right ventricle free wall (RVFW) basal, mid, and mean strain rate imaging prior to, 6 days, and 3 months after OPCAB. SRI 1, RVFW basal strain rate imaging; SR I2, RVFW mid strain rate imaging; mean SRI 1 & 2, the mean of RVFW basal strain rate imaging and RVFW mid strain rate imaging.
Figure 4
Figure 4
Comparison of right ventricle free wall (RVFW) basal, mid, and mean strain rate prior to, 6 days, and 3 months after OPCAB. SR 1, RVFW basal strain rate; SR 2, RVFW mid strain rate; mean SR 1 & 2, the mean of RVFW basal strain rate and RVFW mid strain rate.
See this image and copyright information in PMC

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